Examine the sweeping changes taking place in pharmaceutical medicine including a new code of conduct, federal regulations and industry changes designed to improve drug companies' standards and elevate their performance.

For those who yearn to break their cigarette addiction but don't fancy a trip to the doctor's office, the ability to get the nicotine patch without a physician's prescription may be just what the doctor ordered.

When Stuart Addison goes to the pharmacy in Margate, Fld., he has the pharmacist fill his prescriptions with generic drugs. Addison. a retired federal government auditor, is one of many Americans who are choosing genetics when they buy drugs.

In the face of bad publicity and impending restrictions, trade groups representing pharmaceutical companies have proposed a voluntary plan for using a clinical trials registry as well as results databases by midyear.

The information we get on new prescription drugs from a major and trusted source of information - daily newspapers - is incomplete and may promote unrealistic expectations about the benefits of new drugs, says a study recently released by the Canadian Centre for Policy Alternatives.

The report, Drugs in the News, finds that newspaper articles more often emphasize the benefits of new drugs, while little attention is paid to possible harms. 68% of the news articles examined in more than 20 major newspapers made no mention whatsoever of possible adverse effects, and when identified, these harms were usually downplayed and mentioned towards the end of the article.

The study also found that:

a. The health effects of drugs are often presented using only descriptive terms, without also providing precise or scientific information about the drug's effectiveness.

b. Basic information that quantified the benefits or harms of the drugs was reported in only one out of every four articles, and when it was provided, 30% of the time it was presented in misleading terms.

c. When possible harmful effects were mentioned, they were more often described with language that downplayed the risk to patients ("minor" or "rare"), while benefits were more often described using language that emphasized the potential benefit ("proven remedy" or "highly effective").

d. Contraindications - those conditions under which it is not safe to take the drugs - were mentioned in only 4% of the articles.

e. Only one in six articles mentioned alternative treatment options (for example, an existing, cheaper drug).

f. The financial interests at work behind the scenes - such as who funded a study about a drug's effectiveness, or the financial relationship of a patient spokesperson to the drug company - were noted less than 3% of the time.

The study's authors agree, however, that reporting on pharmaceuticals isn't easy for journalists. "It requires an ability to interpret complex scientific information while resisting the pharmaceutical industry's aggressive marketing techniques," says Barbara Mintzes, co-author of the study. "Pharmaceutical companies make it very easy to write favourable stories about new drugs, while independent drug information is harder to find."

Dr. Joel Lexchin, an emergency department physician in Toronto and associate professor in the School of Health Policy and Management at York University, says he hopes the study will help journalists when they report on new medications. "The media needs to do a better job of following the money so that readers can be better informed."

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